In silico predictions of gastrointestinal drug absorption in pharmaceutical product development: application of the mechanistic absorption model GI-Sim.

Oral drug delivery is the predominant administration route for a major part of the pharmaceutical products used worldwide. Further understanding and improvement of gastrointestinal drug absorption predictions is currently a highly prioritized area of research within the pharmaceutical industry. The fraction absorbed (fabs) of an oral dose after administration of a solid dosage form is a key parameter in the estimation of the in vivo performance of an orally administrated drug formulation. This study discloses an evaluation of the predictive performance of the mechanistic physiologically based absorption model GI-Sim. GI-Sim deploys a compartmental gastrointestinal absorption and transit model as well as algorithms describing permeability, dissolution rate, salt effects, partitioning into micelles, particle and micelle drifting in the aqueous boundary layer, particle growth and amorphous or crystalline precipitation. Twelve APIs with reported or expected absorption limitations in humans, due to permeability, dissolution and/or solubility, were investigated. Predictions of the intestinal absorption for different doses and formulations were performed based on physicochemical and biopharmaceutical properties, such as solubility in buffer and simulated intestinal fluid, molecular weight, pK(a), diffusivity and molecule density, measured or estimated human effective permeability and particle size distribution. The performance of GI-Sim was evaluated by comparing predicted plasma concentration-time profiles along with oral pharmacokinetic parameters originating from clinical studies in healthy individuals. The capability of GI-Sim to correctly predict impact of dose and particle size as well as the in vivo performance of nanoformulations was also investigated. The overall predictive performance of GI-Sim was good as >95% of the predicted pharmacokinetic parameters (C(max) and AUC) were within a 2-fold deviation from the clinical observations and the predicted plasma AUC was within one standard deviation of the observed mean plasma AUC in 74% of the simulations. GI-Sim was also able to correctly capture the trends in dose- and particle size dependent absorption for the study drugs with solubility and dissolution limited absorption, respectively. In addition, GI-Sim was also shown to be able to predict the increase in absorption and plasma exposure achieved with nanoformulations. Based on the results, the performance of GI-Sim was shown to be suitable for early risk assessment as well as to guide decision making in pharmaceutical formulation development.

[1]  N. Ford,et al.  Pharmacokinetics and Pharmacodynamics of Irbesartan in Healthy Subjects , 1998, Journal of clinical pharmacology.

[2]  P. Artursson,et al.  A method for the determination of cellular permeability coefficients and aqueous boundary layer thickness in monolayers of intestinal epithelial caco 2 cells grown in permeable filter chambers , 1991 .

[3]  M. Eadie,et al.  Single oral dose pharmacokinetics and comparative bioavailability of danazol in humans , 1991, Biopharmaceutics & drug disposition.

[4]  S. Yamashita,et al.  Rate-Limiting Steps of Oral Absorption for Poorly Water-Soluble Drugs in Dogs; Prediction from a Miniscale Dissolution Test and a Physiologically-Based Computer Simulation , 2008, Pharmaceutical Research.

[5]  N. Hosten,et al.  Intestinal fluid volumes and transit of dosage forms as assessed by magnetic resonance imaging , 2005, Alimentary pharmacology & therapeutics.

[6]  Malcolm Rowland,et al.  PHRMA CPCDC initiative on predictive models of human pharmacokinetics, part 5: prediction of plasma concentration-time profiles in human by using the physiologically-based pharmacokinetic modeling approach. , 2011, Journal of pharmaceutical sciences.

[7]  F. Bartholomeusz,et al.  The pharmacokinetics of ketoconazole after chronic administration in adults , 2004, European Journal of Clinical Pharmacology.

[8]  Caroline A. Lee,et al.  Drug–Drug Interactions Mediated Through P‐Glycoprotein: Clinical Relevance and In Vitro–In Vivo Correlation Using Digoxin as a Probe Drug , 2009, Clinical pharmacology and therapeutics.

[9]  R. Heel,et al.  Enalapril. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic use in hypertension and congestive heart failure. , 1986, Drugs.

[10]  K. Sugano Fraction of a dose absorbed estimation for structurally diverse low solubility compounds. , 2011, International journal of pharmaceutics.

[11]  W. L. Chiou,et al.  A comprehensive account on the role of efflux transporters in the gastrointestinal absorption of 13 commonly used substrate drugs in humans. , 2001, International journal of clinical pharmacology and therapeutics.

[12]  P. Pentikäinen,et al.  Effect of particle size on the bioavailability of digoxin , 1975, European Journal of Clinical Pharmacology.

[13]  S. Mohr,et al.  Using droplet-based microfluidic technology to study the precipitation of a poorly water-soluble weakly basic drug upon a pH-shift. , 2013, The Analyst.

[14]  Kiyohiko Sugano,et al.  Introduction to computational oral absorption simulation. , 2009, Expert opinion on drug metabolism & toxicology.

[15]  G L Amidon,et al.  Saturable small intestinal drug absorption in humans: modeling and interpretation of cefatrizine data. , 1998, European journal of pharmaceutics and biopharmaceutics : official journal of Arbeitsgemeinschaft fur Pharmazeutische Verfahrenstechnik e.V.

[16]  Walter Schmitt,et al.  A physiological model for the estimation of the fraction dose absorbed in humans. , 2004, Journal of medicinal chemistry.

[17]  Hannah M Jones,et al.  Simulation of Human Intravenous and Oral Pharmacokinetics of 21 Diverse Compounds Using Physiologically Based Pharmacokinetic Modelling , 2011, Clinical pharmacokinetics.

[18]  P. A. Todd,et al.  Lisinopril. A preliminary review of its pharmacodynamic and pharmacokinetic properties, and therapeutic use in hypertension and congestive heart failure. , 1988, Drugs.

[19]  Hans Lennernäs,et al.  Toward an increased understanding of the barriers to colonic drug absorption in humans: implications for early controlled release candidate assessment. , 2009, Molecular pharmaceutics.

[20]  R. Löbenberg,et al.  Modern bioavailability, bioequivalence and biopharmaceutics classification system. New scientific approaches to international regulatory standards , 2000 .

[21]  Eva Karlsson,et al.  Simulating fasted human intestinal fluids: understanding the roles of lecithin and bile acids. , 2010, Molecular pharmaceutics.

[22]  H K Kroemer,et al.  The role of intestinal P-glycoprotein in the interaction of digoxin and rifampin. , 1999, The Journal of clinical investigation.

[23]  Bruno H. Zimm,et al.  Apparatus and Methods for Measurement and Interpretation of the Angular Variation of Light Scattering; Preliminary Results on Polystyrene Solutions , 1948 .

[24]  K. Pang Modeling of intestinal drug absorption: roles of transporters and metabolic enzymes (for the Gillette Review Series). , 2003, Drug metabolism and disposition: the biological fate of chemicals.

[25]  H. Lennernäs,et al.  The effect of ketoconazole on the in vivo intestinal permeability of fexofenadine using a regional perfusion technique. , 2003, British journal of clinical pharmacology.

[26]  Ulf Olsson,et al.  Nucleation and crystal growth in supersaturated solutions of a model drug. , 2008, Journal of colloid and interface science.

[27]  V. Lukacova,et al.  Predicting Pharmacokinetics of Drugs Using Physiologically Based Modeling—Application to Food Effects , 2009, The AAPS Journal.

[28]  J. Paulson,et al.  Pharmacokinetic evaluation in man of terbutaline given as separate enantiomers and as the racemate. , 1989, British journal of clinical pharmacology.

[29]  Hans Lennernäs,et al.  EXPERIMENTAL ESTIMATION OF THE EFFECTIVE UNSTIRRED WATER LAYER THICKNESS IN THE HUMAN JEJUNUM, AND ITS IMPORTANCE IN ORAL-DRUG ABSORPTION , 1995 .

[30]  J. Ansquer,et al.  Comparison of the Gastrointestinal Absorption and Bioavailability of Fenofibrate and Fenofibric Acid in Humans , 2010, Journal of clinical pharmacology.

[31]  K. Goumas,et al.  Precipitation in and Supersaturation of Contents of the Upper Small Intestine After Administration of Two Weak Bases to Fasted Adults , 2011, Pharmaceutical Research.

[32]  Gloria Kwei,et al.  The role of biopharmaceutics in the development of a clinical nanoparticle formulation of MK-0869: a Beagle dog model predicts improved bioavailability and diminished food effect on absorption in human. , 2004, International journal of pharmaceutics.

[33]  M. Brandsch,et al.  Pharmaceutical and pharmacological importance of peptide transporters , 2008, The Journal of pharmacy and pharmacology.

[34]  S. Symchowicz,et al.  Absorption, distribution, metabolism, and excretion of griseofulvin in man and animals. , 1975, Drug metabolism reviews.

[35]  K Gubernator,et al.  Physicochemical high throughput screening: parallel artificial membrane permeation assay in the description of passive absorption processes. , 1998, Journal of medicinal chemistry.

[36]  M. Skiba,et al.  Stability assessment of ketoconazole in aqueous formulations. , 2000, International journal of pharmaceutics.

[37]  S. Symchowicz,et al.  Absorption, metabolism and excretion of 14C-griseofulvin in man. , 1973, The Journal of pharmacology and experimental therapeutics.

[38]  H. Lennernäs,et al.  Transport Characteristics of Fexofenadine in the Caco-2 Cell Model , 2004, Pharmaceutical Research.

[39]  R. Schweins,et al.  Liposome formation from bile salt-lipid micelles in the digestion and drug delivery model FaSSIF(mod) estimated by combined time-resolved neutron and dynamic light scattering. , 2011, Molecular pharmaceutics.

[40]  Lawrence J. Henderson,et al.  CONCERNING THE RELATIONSHIP BETWEEN THE STRENGTH OF ACIDS AND THEIR CAPACITY TO PRESERVE NEUTRALITY , 1908 .

[41]  S. Waldman,et al.  Pharmacokinetics of Aprepitant After Single and Multiple Oral Doses in Healthy Volunteers , 2006, Journal of clinical pharmacology.

[42]  K. Kripalani,et al.  Biotransformation of irbesartan in man. , 1998, Drug metabolism and disposition: the biological fate of chemicals.

[43]  M. Carvajal,et al.  Assessment of milling-induced disorder of two pharmaceutical compounds. , 2011, Journal of pharmaceutical sciences.

[44]  G. Amidon,et al.  Physiological parameters for oral delivery and in vitro testing. , 2010, Molecular pharmaceutics.

[45]  X. Ming,et al.  Vectorial transport of fexofenadine across Caco-2 cells: involvement of apical uptake and basolateral efflux transporters. , 2011, Molecular pharmaceutics.

[46]  A. E. Nielsen DIFFUSION CONTROLLED GROWTH OF A MOVING SPHERE. THE KINETICS OF CRYSTAL GROWTH IN POTASSIUM PERCHLORATE PRECIPITATION , 1961 .

[47]  Jennifer B Dressman,et al.  Dissolution enhancement of fenofibrate by micronization, cogrinding and spray-drying: comparison with commercial preparations. , 2008, European journal of pharmaceutics and biopharmaceutics : official journal of Arbeitsgemeinschaft fur Pharmazeutische Verfahrenstechnik e.V.

[48]  M. Aapro,et al.  Aprepitant: drug-drug interactions in perspective. , 2010, Annals of oncology : official journal of the European Society for Medical Oncology.

[49]  C. Denton,et al.  THE EFFECT OF A SURFACTANT AND OF PARTICLE SIZE ON GRISEOFULVIN PLASMA LEVELS. , 1964, The Journal of investigative dermatology.

[50]  S. Riegelman,et al.  Absorption characteristics of solid dispersed and micronized griseofulvin in man. , 1971, Journal of pharmaceutical sciences.

[51]  Filippos Kesisoglou,et al.  Understanding the Effect of API Properties on Bioavailability Through Absorption Modeling , 2008, The AAPS Journal.

[52]  G. Benedek,et al.  Quasielastic light-scattering studies of aqueous biliary lipid systems. Mixed micelle formation in bile salt-lecithin solutions. , 1980, Biochemistry.

[53]  L. Benet,et al.  The drug efflux-metabolism alliance: biochemical aspects. , 2001, Advanced drug delivery reviews.

[54]  M. Hedeland,et al.  Effect of erythromycin on the absorption of fexofenadine in the jejunum, ileum and colon determined using local intubation in healthy volunteers. , 2006, International journal of clinical pharmacology and therapeutics.

[55]  G L Amidon,et al.  A compartmental absorption and transit model for estimating oral drug absorption. , 1999, International journal of pharmaceutics.

[56]  John S. Huang,et al.  Study of Schultz distribution to model polydispersity of microemulsion droplets , 1988 .

[57]  M. Rogge,et al.  Effect of Food and a Monoglyceride Emulsion Formulation on Danazol Bioavailability , 1993, Journal of clinical pharmacology.

[58]  Anette Müllertz,et al.  Effect of liquid volume and food intake on the absolute bioavailability of danazol, a poorly soluble drug. , 2005, European journal of pharmaceutical sciences : official journal of the European Federation for Pharmaceutical Sciences.

[59]  A Rostami-Hodjegan,et al.  Interplay of metabolism and transport in determining oral drug absorption and gut wall metabolism: a simulation assessment using the "Advanced Dissolution, Absorption, Metabolism (ADAM)" model. , 2010, Current drug metabolism.

[60]  W. Hauck,et al.  Interpatient variability in bioavailability is related to the extent of absorption: Implications for bioavailability and bioequivalence studies , 1996, Clinical pharmacology and therapeutics.

[61]  J. Caldwell,et al.  The metabolism and disposition of 14C-fenofibrate in human volunteers. , 1990, Drug metabolism and disposition: the biological fate of chemicals.

[62]  B Agoram,et al.  Predicting the impact of physiological and biochemical processes on oral drug bioavailability. , 2001, Advanced drug delivery reviews.

[63]  J. Heykants,et al.  Pharmacokinetics and dose proportionality of ketoconazole in normal volunteers , 1986, Antimicrobial Agents and Chemotherapy.

[64]  C. Regårdh,et al.  Felodipine kinetics in healthy men , 1985, Clinical pharmacology and therapeutics.

[65]  Xinyuan Zhang,et al.  The role of predictive biopharmaceutical modeling and simulation in drug development and regulatory evaluation. , 2011, International journal of pharmaceutics.

[66]  P. Artursson,et al.  Comparison of drug transporter gene expression and functionality in Caco-2 cells from 10 different laboratories. , 2008, European journal of pharmaceutical sciences : official journal of the European Federation for Pharmaceutical Sciences.

[67]  Lawrence X. Yu,et al.  Utility of Physiologically Based Absorption Modeling in Implementing Quality by Design in Drug Development , 2011, The AAPS Journal.

[68]  Antonello Caruso,et al.  Application of PBPK modeling to predict human intestinal metabolism of CYP3A substrates - an evaluation and case study using GastroPlus. , 2012, European journal of pharmaceutical sciences : official journal of the European Federation for Pharmaceutical Sciences.

[69]  Lawrence X. Yu,et al.  Compartmental transit and dispersion model analysis of small intestinal transit flow in humans , 1996 .

[70]  D. J. Pack,et al.  Dose proportionality and comparison of single and multiple dose pharmacokinetics of fexofenadine (MDL 16 455) and its enantiomers in healthy male volunteers , 1998, Biopharmaceutics & drug disposition.

[71]  Anette Müllertz,et al.  Insights into intermediate phases of human intestinal fluids visualized by atomic force microscopy and cryo-transmission electron microscopy ex vivo. , 2012, Molecular pharmaceutics.

[72]  Alex Avdeef,et al.  How well can the Caco-2/Madin-Darby canine kidney models predict effective human jejunal permeability? , 2010, Journal of medicinal chemistry.

[73]  A. Straughn,et al.  Bioavailability of microsize and ultramicrosize griseofulvin products in man , 1980, Journal of Pharmacokinetics and Biopharmaceutics.

[74]  Paavo Honkakoski,et al.  Inhibition and induction of human cytochrome P450 enzymes: current status , 2008, Archives of Toxicology.

[75]  P. Neuvonen,et al.  Itraconazole greatly increases plasma concentrations and effects of felodipine , 1997, Clinical pharmacology and therapeutics.

[76]  J. Dressman,et al.  Evolution of a detailed physiological model to simulate the gastrointestinal transit and absorption process in humans, part 1: oral solutions. , 2011, Journal of pharmaceutical sciences.

[77]  P. Lu,et al.  CYTOCHROME P450 3A4 IS THE MAJOR ENZYME INVOLVED IN THE METABOLISM OF THE SUBSTANCE P RECEPTOR ANTAGONIST APREPITANT , 2004, Drug Metabolism and Disposition.

[78]  Neil Parrott,et al.  Applications of physiologically based absorption models in drug discovery and development. , 2008, Molecular pharmaceutics.

[79]  Malcolm Rowland,et al.  Pharmacokinetics of fexofenadine: evaluation of a microdose and assessment of absolute oral bioavailability. , 2010, European journal of pharmaceutical sciences : official journal of the European Federation for Pharmaceutical Sciences.

[80]  Hans Lennernäs,et al.  The Effects of Food on the Dissolution of Poorly Soluble Drugs in Human and in Model Small Intestinal Fluids , 2005, Pharmaceutical Research.

[81]  D. Greenblatt,et al.  Dose-independent pharmacokinetics of digoxin in humans. , 1978, American heart journal.

[82]  Mikiko Shimizu,et al.  Lack of Dose-Dependent Effects of Itraconazole on the Pharmacokinetic Interaction with Fexofenadine , 2006, Drug Metabolism and Disposition.

[83]  M Rowland,et al.  Best Practice in the Use of Physiologically Based Pharmacokinetic Modeling and Simulation to Address Clinical Pharmacology Regulatory Questions , 2012, Clinical pharmacology and therapeutics.

[84]  H. Lennernäs,et al.  Predicting Intestinal Precipitation—A Case Example for a Basic BCS Class II Drug , 2010, Pharmaceutical Research.

[85]  Leslie Z. Benet,et al.  Predicting drug absorption and the effects of food on oral bioavailability , 2006 .

[86]  S. Jönsson,et al.  Role of Modelling and Simulation , 2012, Clinical Pharmacokinetics.

[87]  Jelena Parojcić,et al.  Justification of biowaiver for carbamazepine, a low soluble high permeable compound, in solid dosage forms based on IVIVC and gastrointestinal simulation. , 2009, Molecular pharmaceutics.

[88]  W. Shyu,et al.  Oral Bioavailability and Disposition Characteristics of Irbesartan, an Angiotensin Antagonist, in Healthy Volunteers , 1998, Journal of clinical pharmacology.

[89]  B. Brodie,et al.  On the mechanism of intestinal absorption of drugs. , 1959, The Journal of pharmacology and experimental therapeutics.

[90]  N. Yasui-Furukori,et al.  Different Effects of Three Transporting Inhibitors, Verapamil, Cimetidine, and Probenecid, on Fexofenadine Pharmacokinetics , 2005, Clinical pharmacology and therapeutics.

[91]  E. Johnson,et al.  Influence of food on the pharmacokinetics of ketoconazole , 1984, Antimicrobial Agents and Chemotherapy.

[92]  J. Crison,et al.  A Theoretical Basis for a Biopharmaceutic Drug Classification: The Correlation of in Vitro Drug Product Dissolution and in Vivo Bioavailability , 1995, Pharmaceutical Research.

[93]  H Lennernäs,et al.  Intestinal permeability and its relevance for absorption and elimination , 2007, Xenobiotica; the fate of foreign compounds in biological systems.

[94]  D. Kroetz,et al.  Human liver carbamazepine metabolism. Role of CYP3A4 and CYP2C8 in 10,11-epoxide formation. , 1994, Biochemical pharmacology.

[95]  R. Alonso,et al.  pK(a) determination of angiotensin II receptor antagonists (ARA II) by spectrofluorimetry. , 2001, Journal of pharmaceutical and biomedical analysis.

[96]  U. Hofmann,et al.  Increased Absorption of Digoxin from the Human Jejunum Due to Inhibition of Intestinal Transporter-Mediated Efflux , 2007, Clinical pharmacokinetics.

[97]  A. Weil,et al.  Absence of a food effect with a 145 mg nanoparticle fenofibrate tablet formulation. , 2006, International journal of clinical pharmacology and therapeutics.

[98]  Kazuya Maeda,et al.  CONTRIBUTION OF OATP (ORGANIC ANION-TRANSPORTING POLYPEPTIDE) FAMILY TRANSPORTERS TO THE HEPATIC UPTAKE OF FEXOFENADINE IN HUMANS , 2005, Drug Metabolism and Disposition.